Scottish teens report adverse health effects from unregulated nicotine pouch use

Teenagers in Scotland are experimenting with unregulated nicotine pouches and reporting adverse effects such as sickness, fainting and gum pain, according to new research published in Addiction.

The study, led by the Scottish Centre for Social Research (ScotCen), represents the first qualitative research in the UK to explore how young people aged 14 to 16 understand and use nicotine pouches.

These small, tobacco-free sachets are placed between the gum and lip to deliver nicotine. They have been legally available in the UK since 2019, are currently unregulated and can be sold to under-18s.

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Researchers carried out 16 focus groups with 77 pupils and interviewed 13 staff members across four Scottish secondary schools.

Awareness of the products was widespread among pupils, who often referred to them as ‘snus’ or ‘upper deckies’. Experimental use was common, and regular use was reported particularly among older male pupils.

Some pupils believed the products were a safer alternative to smoking or vaping because they did not affect the lungs. One male pupil told researchers: ‘I’d rather have worse gums than worse lungs.’

However, many pupils described adverse effects from using pouches, including gum pain, burning sensations in the mouth and throat, nausea, sweating and fainting.

School staff said they were generally aware of vaping among pupils and had measures in place to address it, but most had limited knowledge of nicotine pouches and were unaware that they were being used in schools.

Andy MacGregor, director of policy research at ScotCen, said: ‘Our study shows that awareness and experimentation with nicotine pouches among young people is already widespread and that these products are being used under the radar in schools.

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‘Because pouches can be bought by under-18s and used discreetly, they pose a unique challenge for teachers, parents and policymakers. Stronger regulation and better public health messaging are urgently needed.’

Last month, the UK government announced plans that would require retailers in England and Wales to hold a licence to sell vapes, nicotine products and tobacco.

Allison Ford, associate professor at the Institute for Social Marketing and Health at the University of Stirling and principal investigator of the New Nicotine Products in Scotland (NIPS) study, said: ‘The wider NIPS study is examining the retail availability, marketing and display of NNPs in Scotland.

‘Its findings will help the Scottish Government decide if new rules are needed on how vapes and nicotine pouches are displayed and marketed in shops, to protect young people from using these products.’

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In February this year, the UK government announced a 10-year study to investigate the long-term effects of vaping on children and young people’s health.

The research will track 100,000 young people aged eight to 18 years and collect data on behaviour, biology and health records.